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Contact Dermatitis. Edited By: Wolfgang Uter.
- Irritant contact dermatitis!
- Contact dermatitis.
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- Contact Dermatitis (Allergic and Irritant).
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Impact factor: 5. Online ISSN: Allergic contact stomatitis caused by meth acrylates in an occlusal splint Anna S. Quaade Marianne Hald Jeanne D. Friis Maja G. Deleuran Claus Zachariae Jacob P. Skin prick and radioallergosorbent tests are used for the diagnosis of type I hypersensitivity, such as respiratory, latex, and food allergies, but not for contact dermatitis.
Adapted with permission from T. Accessed April 15, A Allergic contact dermatitis from a chemical in hair dye. B Patch testing in the same patient.
See Table 3 for names of each allergen in the panels. If the suspected allergen is not included in the TRUE Test, the patient may be referred to a subspecialist who offers customized patch testing. Personal products, such as cosmetics and lotions, can be diluted for specialized patch testing. However, because it is difficult to clinically distinguish between allergic and irritant contact dermatitis, these agents are often used successfully for the irritant form.
If the patient is comfortable after this initial therapy, the dose may be reduced by 50 percent for the next five to seven days. The rate of reduction of the steroid dosage depends on factors such as the severity and duration of allergic contact dermatitis, and how effectively the allergen can be avoided.
A steroid dose pack has insufficient dosing and duration and should not be prescribed. There is no evidence to support the use of long-acting injectable steroids in the treatment of contact dermatitis. In patients with nickel-induced contact dermatitis, it is helpful to cover the metal tab of jeans with an iron-on patch most effective or a few coats of clear nail polish.
Clear nail polish can also be used on belt buckles, but may need to be reapplied often. Some patients may be allergic to preservatives used in the base of steroid creams. Steroid ointment is recommended because it allows the medication to maintain contact with the skin longer and there is little risk of an allergic reaction allergic reaction to the steroid itself is rare.
Also, soaking the affected areas before applying the steroid is thought to help improve penetration and increase its effectiveness.
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Although antihistamines are generally not effective for pruritus associated with allergic contact dermatitis, they are commonly used. Sedation from more soporific antihistamines e. Already a member or subscriber? Log in.
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Address correspondence to Richard P. Reprints are not available from the authors. Usatine RP. Color Atlas of Family Medicine. The prevalence of back pain, hand discomfort, and dermatitis in the US working population. Am J Public Health. Department of Labor. Workplace injuries and illnesses in Accessed April 19, Contact dermatitis: a practice parameter [published correction appears in Ann Allergy Asthma Immunol. Ann Allergy Asthma Immunol. Prevalence and relevance of contact dermatitis allergens: a meta-analysis of 15 years of published T.
J Am Acad Dermatol. Garner LA. Contact dermatitis to metals. Dermatol Ther. Nickel-induced facial dermatitis: adolescents beware of the cell phone. Contact Dermatitis. Johansen JD. Fragrance contact allergy: a clinical review. Am J Clin Dermatol. Srivastava D, Cohen DE. Identification of the constituents of balsam of Peru in tomatoes. Organic mercury compounds: human exposure and its relevance to public health.
Toxicol Ind Health. Wolff K, Johnson RA, eds. Halstater B, Usatine RP. Guidelines for the management of contact dermatitis: an update. Br J Dermatol. Soak and smear: a standard technique revisited. Arch Dermatol. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.
Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Previous: Medical Management vs. Surgery for Gastroesophageal Reflux Disease. Aug 1, Issue. Diagnosis and Management of Contact Dermatitis. C 3 Localized acute allergic contact dermatitis lesions are successfully treated with mid- or high-potency topical steroids, such as triamcinolone 0. C 4 On areas with thinner skin e. C 4 If allergic contact dermatitis involves extensive areas of the skin greater than 20 percent , systemic steroid therapy is often required and offers relief within 12 to 24 hours.
Features to Help Distinguish Between Irritant and Allergic Contact Dermatitis Feature Irritant Allergic Location Usually the hands Usually exposed areas of skin, often the hands Symptoms Burning, pruritus, pain Pruritus is the dominant symptom Surface appearance Dry and fissured skin Vesicles and bullae Lesion borders Less distinct borders Distinct angles, lines, and borders Information from reference 1.
ACD A-Z of Skin - Irritant contact dermatitis (ICD)
Table 1. A linear pattern of allergic contact dermatitis from poison ivy. Figure 1. Figure 2. Figure 3. Contact dermatitis and latex allergy. Centers for Disease Control website. Accessed December 29, Plake K, Darbishire P. Contact dermatitis. Handbook of Nonprescription Drugs. Medline Plus website. Accessed December 30, Hogan D. Allergic contact dermatitis. Medscape website. American Academy of Dermatology website.
Asthma and Allergy Foundation of America website.